Public Health Transformation: Crafting a Winning Strategy for Public Health

What would it mean for public health to adopt a more strategic approach? Understanding the true essence of being strategic goes beyond running effective programs or having a strategic plan. In this blog post, we will explore different perspectives on what constitutes a winning strategy, how to create one and its implications for public health.

Transforming Public Health for the 21st Century: Bridging Theory to Practice is a blog series that will explore the challenges and opportunities faced by the public health sector and will introduce a roadmap for transformation. Sign up here to receive these summaries and more, and also follow KHI on Facebook, Twitter, LinkedIn, and Instagram. Learn more about the series on our archive page. Please feel free to share your feedback or suggestions with us by emailing info@khi.org.

Strategy as Change

Change is happening at an unprecedented pace. Strategic organizations recognize this and leverage it to their advantage. They adapt quickly and routinely to evolving circumstances and consider their ability to adapt as a strategic advantage. The COVID-19 pandemic showcased the public health system’s ability to adapt, but most threats are not as overt. Returning to pre-pandemic times is insufficient; public health professionals must embrace the transition from infectious to chronic diseases, acknowledge social and structural determinants of health and address the root causes of population health issues. Viewing strategy as change empowers the public health system to take control of the threats facing our communities and build value for our communities, stakeholders and the public health workforce.

Strategy as Playing to Win

Strategy is also about playing to win. It involves creating successful organizations that generate value and become indispensable pillars of their communities. Playing to win means carefully selecting and solving problems at their root cause, rather than merely managing the symptoms. This is a strength of the public health approach, as outlined by physician and epidemiologist Geoffrey Rose in his article, “Sick Individuals and Sick Populations.” Here, he says that the strength of the public health approach is in its ability to alter the underlying causes of disease. Public health interventions, like policy development, community engagement and partnership building have the potential to tackle population health problems for good. Consider that public health interventions accounted for most of the 30 years of increased life expectancy experienced in the U.S. in the 20th century. A public health system that plays to win solves problems, delivers results and garners long-term success.

Strategy as Unique Positioning

Strategy also involves positioning organizations uniquely among their competitors and collaborators. It means identifying what public health can do better than any discipline. This requires a deep understanding of stakeholders and providing unmatched value. In his book, Good to Great, Jim Collins demonstrates how organizations can establish unique positioning by aligning what they can excel at, what they are passionate about, and what powers their economic engine. Strategic organizations build competitive advantage by understanding their stakeholders, their own organizations and how to develop and use their capabilities effectively. Building capabilities may involve securing more resources, fostering stronger partnerships or reallocating resources. For health departments, a unique strategic position could be serving as their community’s chief health strategist – a role that leverages public health’s unique strengths for understanding their community’s needs and assets and marshaling these resources to address public health threats at their root cause. Unique positioning for public health can also help build collaborative advantage by deduplicating efforts and investing in resources that build synergy. Building a unique position for public health organizations could also mean exploring cross-jurisdictional sharing arrangements, which has been identified as a strategy to advance public health in Kansas and other states.

Strategy as Orienting Towards the Future

Strategy requires us to look to the future and understand how present conditions will shape tomorrow. Strategic thinking involves a reasoning process that supports goal-oriented decision-making. Orienting ourselves towards the future involves embracing change and updating our worldviews accordingly. This requires curiosity and openness to new ideas. As Wayne Gretzky famously said, “We need to skate to where the puck is going to be, not to where it has been.” Strategic thinkers are adaptable, future-oriented and open to flexible approaches. The ability to evolve our worldview is crucial. Not because we were initially wrong, but because the surrounding conditions are constantly changing. A future-oriented strategy will allow us to create a public health system better aligned with emerging needs.

What Steps Can Public Health Take to Become More Strategic?

1. Create future-oriented health departments: Identify the trends that will shape the health of our communities and anticipate the pressures that our public health organizations will face. Foster curiosity and an openness to new ideas. Reflect on our worldview and establish mechanisms to challenge and shape it.
2. Leverage health departments’ unique value: Take an honest look at our stakeholders’ needs and the ability of our public health organizations to meet them. How can we align our strengths with their needs? How can we unearth our hidden strengths? How can we build new capabilities?
3. Play to win against critical public health threats: Identify public health threats that are critical for our stakeholders and deliver undeniable results. The problems don’t have to be enormous. But they should be significant in our stakeholders’ eyes. We’ll know when we are playing to win because our goals will cause us some anxiety. Avoiding risk isn’t strategic. Plan for quick wins that build trust and support for public health and build from there.
4. Build a public health system that adapts: Create a clear vision for the big opportunities for the public health system. What breakthroughs could we make that would position us for long-term success? What unites us and generates value for our communities, stakeholders and workforce? How can we develop a coalition of empowered champions who share a sense of urgency and the commitment needed to create the public health system we need for the 21^st century?

Crafting a winning strategy for public health requires a holistic approach that goes beyond programs and plans. It entails building resilient public health organizations capable of adapting to change, playing to win by addressing critical problems and generating value, establishing a distinctive position that sets public health apart, and embracing curiosity and evolving our worldview to anticipate the future. By adopting these strategies, public health organizations can position themselves for success and create a profound impact on the health and well-being of their communities.